ABSTRACT
One hundred consecutive referral letters, sent by dental practitioners to the Department of Oral and Maxillofacial Surgery, Dublin Dental School and Hospital, were audited in terms of quality. The audit was based on the Scottish Intercollegiate Guidelines Network (SIGN) recommendations of 1998. The audit demonstrated that in general referral letters required modification and did not give the clinician the required information. This paper sets out the results of the audit and suggests a template that should be used for future referrals.
Subject(s)
Correspondence as Topic , Dental Audit , Dental Service, Hospital , Referral and Consultation/standards , Surgery, Oral , Dental Records , Forms and Records Control , General Practice , General Practice, Dental , Guideline Adherence , Hospitals, Special , Humans , Interdisciplinary Communication , Schools, Dental , WritingABSTRACT
Antibiotics work by exploiting differences between human and bacterial cells. They are grouped according to their targets of action: cell wall synthesis, protein synthesis, and nucleic acid replication. Generally they should be used as an adjunct to local measures that aim to remove the source of infection and drain pus, usually when infection has spread to adjacent tissue spaces. They should not be used prophylactically after surgical extractions unless significant pre-existing infection is diagnosed.
Subject(s)
Anti-Bacterial Agents/therapeutic use , Bacterial Infections/drug therapy , Periodontal Diseases/microbiology , Tooth Diseases/microbiology , Bacteria/drug effects , Cell Wall/drug effects , Cephalosporins/therapeutic use , Combined Modality Therapy , Debridement , Drainage , Erythromycin/therapeutic use , Humans , Nucleic Acid Synthesis Inhibitors/therapeutic use , Penicillin-Binding Proteins/drug effects , Penicillins/therapeutic use , Periodontal Diseases/drug therapy , Protein Synthesis Inhibitors/therapeutic use , Tetracyclines/therapeutic use , Tooth Diseases/drug therapyABSTRACT
Pericoronitis is an infection associated with impacted lower third molars that can necessitate the removal of these teeth. The clinical features of this condition are described and its treatment outlined, emphasising local measures. A case of pericoronitis in a 52-year-old patient is discussed, which illustrates the risks and benefits of removal of wisdom teeth; removal can lead to nerve damage, retention can precipitate serious, even life-threatening infection.
Subject(s)
Molar, Third , Pericoronitis/therapy , Tooth, Impacted/complications , Anti-Bacterial Agents/therapeutic use , Debridement , Drainage , Female , Humans , Middle Aged , Pericoronitis/etiology , Tooth ExtractionABSTRACT
PURPOSE: To review the literature concerning pericoronitis, in particular the nature of the lesion and its aetiology, what factors may be used to predict if some patients would benefit from early removal of third molars, and if a scoring system can be developed for this purpose. METHOD AND MATERIALS: A literature search using PubMed and the facilities of the Dublin Dental Hospital (DDH) library were used to gather the relevent information. PubMed lists all of the journals available in the DDH library and was used to identify relevent papers, which were then retrieved from the shelves and stacks with the help of library staff. The key word used was 'pericoronitis'. RESULTS: The studies reviewed assert that the bacteriology of pericoronitis is predominantly anaerobic in character, yet no causative species has been identified. Marker organisms for periodontitis were not generally isolated. Host factors examined in various studies were the inflammatory markers interleukin 1b and prostaglandin E2, and the immunological responses of neutrophils, macrophages, natural killer cells, T cells, helper T cells and suppressor/cytotoxic T cells. While all of these factors, with the exception of prostaglandin E2, tend to be elevated in cases of pericoronitis, both symptomatic and asymptomatic, no clearcut measurable entity has emerged that can be used as a predictive marker. CONCLUSION: A hypothesised scoring system to predict which patients would benefit from early removal of asymptomatic impacted lower third molars would be clinically advantageous in justifying prophylactic third molar surgery, but is not yet feasible or proven.
